This study aimed to evaluate the long-term outcome of the regenerative periodontal therapy of an intrabony defect in terms of tooth survival and clinical attachment level (CAL) stability. The association between failure and patient as well as tooth variables was assessed. Treatment records of the patients who received regenerative surgery and re-evaluation at 1-year post-surgery were screened. Patient and tooth variables, defect characteristics, and types of treatments were collected. Periodontal parameters were retrieved before regenerative surgery (baseline), 1-year post-surgery, and every visits of supportive periodontal treatment (SPT) until failure, including tooth loss or CAL loss ≥2 mm was found. In this study, treatment records from 89 patients were included. These patients continued SPT from 0.5–11.16 years. Of these patients, 92.1 % survived from tooth loss, while 61.8 % survived from CAL loss ≥2 mm compared to 1-year post-surgery. At the sites with residual pocket depth <5 mm, patients attending SPT >80 % had a significantly less percentage of teeth with CAL loss ≥2 mm compared to 1-year post-surgery than those attending SPT <80 %. However, at the sites with residual pocket depth ≥5 mm, no significant difference in the percentage of teeth with CAL loss ≥2 mm was found between patients attending SPT >80 % or <80 %. Smoking, patient’s compliance, and residual pocket depth after regenerative surgery were significantly associated with tooth loss. However, these factors were not significantly associated with CAL loss compared to baseline or 1-year post-surgery.
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Bosshardt DD, Sculean A. Does periodontal tissue regeneration really work? Periodontol. 2000;2009(51):208–19.
Hägi TT, Laugisch O, Ivanovic A, Sculean A. Regenerative periodontal therapy. Quintessence Int. 2014;45:185–92.
Eickholz P, Hörr T, Klein F, Hassfeld S, Kim TS. Radiographic parameters for prognosis of periodontal healing of infrabony defects: two different definitions of defect depth. J Periodontol. 2004;75:399–407.
Klein F, Kim TS, Hassfeld S, Staehle HJ, Reitmeir P, Holle R, Eickholz P. Radiographic defect depth and width for prognosis and description of periodontal healing of infrabony defects. J Periodontol. 2001;72:1639–46.
Tonetti MS, Pini-Prato G, Cortellini P. Periodontal regeneration of human intrabony defects. IV. Determinants of healing response. J Periodontol. 1993;64:934–40.
Tsitoura E, Tucker R, Suvan J, Laurell L, Cortellini P, Tonetti M. Baseline radiographic defect angle of the intrabony defect as a prognostic indicator in regenerative periodontal surgery with enamel matrix derivative. J Clin Periodontol. 2004;31:643–7.
Cortellini P, Pini Prato G, Tonetti MS. Pini Prato G, Tonetti MS. Periodontal regeneration of human infrabony defects. II. Re-entry procedures and bone measures. J Periodontol. 1993;64:261–8.
Gottlow J, Nyman S, Karring T. Maintenance of new attachment gained through guided tissue regeneration. J Clin Periodontol. 1992;19:315–7.
Eickholz P, Krigar DM, Kim TS, Reitmeir P, Rawlinson A. Stability of clinical and radiographic results after guided tissue regeneration in infrabony defects. J Periodontol. 2007;78:37–46.
Cortellini P, Tonetti MS. Long-term tooth survival following regenerative treatment of intrabony defects. J Periodontol. 2004;75:672–8.
Orsini M, Orsini G, Benlloch D, Aranda JJ, Sanz M. Long-term clinical results on the use of bone-replacement grafts in the treatment of intrabony periodontal defects. Comparison of the use of autogenous bone graft plus calcium sulfate to autogenous bone graft covered with a bioabsorbable membrane. J Periodontol. 2008;79:1630–7.
Cortellini P, Paolo G, Prato P, Tonetti MS. Long-term stability of clinical attachment following guided tissue regeneration and conventional therapy. J Clin Periodontol. 1996;23:106–11.
Tonetti MS, Pini-Prato G, Cortellini P. Effect of cigarette smoking on periodontal healing following GTR in infrabony defects. A preliminary retrospective study. J Clin Periodontol. 1995;22:229–34.
Miller SC. Textbook of Periodontia: oral medicine. 3rd ed. Philadelphia: Blakiston; 1950.
Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25:229–35.
O’Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43:38.
Demetriou N, Tsami-Pandi A, Parashis A. Compliance with supportive periodontal treatment in private periodontal practice. A 14-year retrospective study. J Periodontol. 1995;66:145–9.
Elkhatat EI, Elkhatat AE, Azzeghaiby SN, Tarakji B, Beshr K, Mossa H. Clinical and radiographic evaluation of periodontal intrabony defects by open flap surgery alone or in combination with Biocollagen® membrane: a randomized clinical trial. J Int Soc Prev Community Dent. 2015;5:190–8.
Keles GC, Sumer M, Cetinkaya BO, Tutkun F, Simsek SB. Effect of autogenous cortical bone grafting in conjunction with guided tissue regeneration in the treatment of intraosseous periodontal defects. Eur J Dent. 2010;4:403–11.
McGuire MK, Nunn ME. Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol. 1996;67:666–74.
Camargo P, Klokevold P, Lekovic V. Reevaluation after a bone fill regenerative procedure. In: Hall WB, editor. Critical decisions in periodontology. 4th ed. Ontario: BC Decker; 2003. p. 194–5.
Hiatt WH, Schallhorn RG, Aaronian AJ. The induction of new bone and cementum formation: IV. Microscopic examination of the periodontium following human bone and marrow allograft, autograft and nongraft periodontal regenerative procedures. J Periodontol. 1978;49:495–512.
Laurell L, Gottlow J, Zybutz M, Persson R. Treatment of intrabony defects by different surgical procedures. A literature review. J Periodontol. 1998;69:303–13.
Kingman A, Löe H, Ånerud Å, Boysen H. Errors in measuring parameters associated with periodontal health and disease. J Periodontol. 1991;62:477–86.
Jackson Lu H-K. Topographical characteristics of root trunk length related to guided tissue regeneration. J Periodontol. 1992;63:215–9.
Villaça JH, Rodrigues DC, Novaes AB, Taba M, Souza SLS, Grisi MFM. Root trunk concavities as a risk factor for regenerative procedures of class II furcation lesions in humans. J Periodontol. 2004;75:1493–9.
Novaes AB Jr, Tamani JP, Oliveira PT, Palioto DB, Almeida AL. Root trunk concavities as a risk factor for regenerative procedures of class II furcation lesions in dogs. J Periodontol. 2001;72:612–9.
This study was funded by the Faculty of Dentistry, Mahidol University (Grant Number 06/2558).
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The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
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Rattanasuwan, K., Lertsukprasert, K., Rassameemasmaung, S. et al. Long-term outcome following regenerative periodontal treatment of intrabony defects. Odontology 105, 191–201 (2017). https://doi.org/10.1007/s10266-016-0250-9
- Clinical attachment level
- Long-term outcome
- Periodontal regeneration
- Retrospective study
- Tooth survival